Diagnostic accuracy and distress associated with oropharyngeal suction in cystic fibrosis

Doumit, M; Belessis, Y; Stelzer-Braid, S; Mallitt, KA; Rawlinson, W; Jaffe, A

Diagnostic accuracy and distress associated with oropharyngeal suction in cystic fibrosis

Doumit, M Belessis, Y Stelzer-Braid, S

Mallitt, KA Rawlinson, W Jaffe, A

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Publication Type:: Journal Article
Citation:: Journal of Cystic Fibrosis, 2016, 15 (4), pp. 473 - 478
Issue Date:: 2016-07-01

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Field	Value	Language
dc.contributor.author	Doumit, M	en_US
dc.contributor.author	Belessis, Y	en_US
dc.contributor.author	Stelzer-Braid, S https://orcid.org/0000-0001-6037-9305	en_US
dc.contributor.author	Mallitt, KA	en_US
dc.contributor.author	Rawlinson, W	en_US
dc.contributor.author	Jaffe, A	en_US
dc.date.available	2015-09-02	en_US
dc.date.issued	2016-07-01	en_US
dc.identifier.citation	Journal of Cystic Fibrosis, 2016, 15 (4), pp. 473 - 478	en_US
dc.identifier.issn	1569-1993	en_US
dc.identifier.uri	http://hdl.handle.net/10453/107600
dc.description.abstract	© 2015 Background Early detection of bacterial pathogens in the lower airway is an important part of managing CF. This study aimed to assess the diagnostic accuracy of oropharyngeal suction (OPS) samples in obtaining airway bacterial cultures in young children with cystic fibrosis (CF), and the level of child distress caused by obtaining OPS samples. Methods Young children with CF undergoing broncho-alveolar lavage (BAL) as part of concurrent research or routine annual surveillance were studied. OPS was performed by stimulating a cough and suctioning the back of the oropharynx in the awake child to replicate clinical practice. BAL of the right upper, middle and lingula lobes was then performed. Samples were sent for standard bacterial culture. The child's distress during OPS was rated using the Groningen Distress Scale (1 = calm, 2 = timid/nervous, 3 = serious distress but still under control, 4 = serious distress with loss of control, 5 = panic). Results There were 65 paired samples obtained from 39 children (21 boys, mean age on day of first sampling was 34.1 months, SD 19.1 months). For Pseudomonas aeruginosa, specificity, sensitivity, NPV and PPV with 95% CI were 98% (87–99), 75% (20–96), 98% (91–98) and 60% (15–93%) respectively. In all age groups combined, median level of distress was 3 (IQR 2–4), with distress highest in 2 and 3 year olds, with a median of 4 (IQR 3–4). Conclusion OPS has diagnostic utility in determining the absence of organisms in the lower airway, with specificity for P.aeruginosa detection of 98%. However, a positive OPS result is not necessarily a good indicator of lower airway infection. Distress levels were high during OPS, mostly in 2 and 3 year olds.	en_US
dc.relation.ispartof	Journal of Cystic Fibrosis	en_US
dc.relation.isbasedon	10.1016/j.jcf.2015.09.001	en_US
dc.subject.classification	Respiratory System	en_US
dc.subject.mesh	Oropharynx	en_US
dc.subject.mesh	Sputum	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Pseudomonas aeruginosa	en_US
dc.subject.mesh	Pseudomonas Infections	en_US
dc.subject.mesh	Respiratory Tract Infections	en_US
dc.subject.mesh	Cystic Fibrosis	en_US
dc.subject.mesh	Psychomotor Agitation	en_US
dc.subject.mesh	Early Diagnosis	en_US
dc.subject.mesh	Specimen Handling	en_US
dc.subject.mesh	Suction	en_US
dc.subject.mesh	Bronchoalveolar Lavage	en_US
dc.subject.mesh	Child, Preschool	en_US
dc.subject.mesh	Infant	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Dimensional Measurement Accuracy	en_US
dc.title	Diagnostic accuracy and distress associated with oropharyngeal suction in cystic fibrosis	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	15	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	15	en_US

Abstract:

© 2015 Background Early detection of bacterial pathogens in the lower airway is an important part of managing CF. This study aimed to assess the diagnostic accuracy of oropharyngeal suction (OPS) samples in obtaining airway bacterial cultures in young children with cystic fibrosis (CF), and the level of child distress caused by obtaining OPS samples. Methods Young children with CF undergoing broncho-alveolar lavage (BAL) as part of concurrent research or routine annual surveillance were studied. OPS was performed by stimulating a cough and suctioning the back of the oropharynx in the awake child to replicate clinical practice. BAL of the right upper, middle and lingula lobes was then performed. Samples were sent for standard bacterial culture. The child's distress during OPS was rated using the Groningen Distress Scale (1 = calm, 2 = timid/nervous, 3 = serious distress but still under control, 4 = serious distress with loss of control, 5 = panic). Results There were 65 paired samples obtained from 39 children (21 boys, mean age on day of first sampling was 34.1 months, SD 19.1 months). For Pseudomonas aeruginosa, specificity, sensitivity, NPV and PPV with 95% CI were 98% (87–99), 75% (20–96), 98% (91–98) and 60% (15–93%) respectively. In all age groups combined, median level of distress was 3 (IQR 2–4), with distress highest in 2 and 3 year olds, with a median of 4 (IQR 3–4). Conclusion OPS has diagnostic utility in determining the absence of organisms in the lower airway, with specificity for P.aeruginosa detection of 98%. However, a positive OPS result is not necessarily a good indicator of lower airway infection. Distress levels were high during OPS, mostly in 2 and 3 year olds.

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http://hdl.handle.net/10453/107600